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PANDEMIC ALERT LEVEL
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Now tracking the new emerging South Africa Omicron Variant

Have we lost any chance of containment?

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DarlMan View Drop Down
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    Posted: January 13 2006 at 7:58am
It may be just my own impression but it seems the WHO is ping-pong’ing back and forth on the situation with H5N1. In some reports they seem to be down playing it heavily and then 24 hours later push the edge of using words like “current epidemic” or “pandemic likely”.

Has any chance of containing the spread of the virus been lost?

Does the current apparent increase of infection in Turkey represent a significant change in H5N1 or are cultural and environmental factors the reason for seemingly larger numbers of human infections?

There are many experts that are sounding the alarm, but there are also many experts who are less worried about a pandemic for instance Dr. Butcher (Avian Virologist) from Florida says the following:

--Begin Quote
“Butcher does not doubt the world is in for another pandemic, he said. But the constant hum of warnings in this country about the avian flu irks him -- especially since influenza has long infected about 30 percent of the native wild duck population when it migrates annually to Canada. As the weather turns cold, the birds migrate south through the United States. "This occurs every year," Butcher said. "We very, very rarely have infections spread to commercial poultry."

The H5N1 virus is a much more serious strain, he said, but it poses no greater threat of human infection.

"The threat is basically zero," he said. "We're spending all of our attention on this (virus), and another one may sneak up on us."

---End Quote

So how does a layperson remove the wheat from the chaff?

I see reports about large number of geese dying in Arkansas. They say it is PROBABLY avian cholera!! Probably is useless just tell me what it IS!!

I have been watching the developing BF crisis since it re-emerged in China. Even though it spread throughout SE Asian, human infection came in small and manageable numbers. Now in Turkey we see a brushfire of cases. Is the next logical step a wildfire of cases or as a layperson am I missing a significant understanding?

I just want to know what the deal is…
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Guests Quote  Post ReplyReply Direct Link To This Post Posted: January 13 2006 at 8:12am
The outbreak in Turkey is PQ Bird Flu.  (Post Qinghai mutated virus that I call Sichuan Sheet)  It has a high lethality.  Because of that, it does not spread as easily. 

For the virus to spread more easily, it needs to dumb down its capacity to kill.  (Dead people do not spread the virus very well. Dead birds don't either.)

Thus, when we see that there are asymptomatic birds, we know that it can spread in the bird population,  AND, it has.

Once it picks up human receptors (possibly with recombination with H9N2) it will be able to spread more readily, but it won't last long as long as it keeps on killing it's human hosts. 

THAT is the reason I keep on saying that when it gets down to a lethality of approximately 1 percent or less THEN we will have a pandemic of "Mild Flu."  (Mild compared to the far higher lethality numbers bandied forth by so many on all of the flu boards.)
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Post Options Post Options   Thanks (0) Thanks(0)   Quote DarlMan Quote  Post ReplyReply Direct Link To This Post Posted: January 13 2006 at 8:29am
Interesting,

Now for a dumb question. If the strain in Turkey is of highly lethal strain and dead birds don't fly then why are so many saying Turkey was hit because of migratory patterns in wildbirds? This maybe over simplistic, but if I follow your scenerio then a bird with a mutated less lethal form took the virus to Turkey where it devolved back into the more lethal strain.

BTW - This is not a smarta#@ question. I really find it confusing.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Guests Quote  Post ReplyReply Direct Link To This Post Posted: January 13 2006 at 8:41am
NOPE!  An asymptomatic bird carried the lethal strain and spread it wherever it flew.  The asymptomatic bird is not injured by the flu that it is carrying.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Deej Quote  Post ReplyReply Direct Link To This Post Posted: January 13 2006 at 8:42am

joe, basically what you are saying is that bf is a virus that wants to live, by killing its host, the chances of its survival are minimal, thus it needs to become less deadly and more easily spread ?... but what about the 1918 flu---  i have not read much in this area, how is this different, or similar?

dee
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Guests Quote  Post ReplyReply Direct Link To This Post Posted: January 13 2006 at 8:52am
Think in terms of Typhoid Mary.  She carried the Typhoid illness and passed it along to many others.  Asymptomatic birds are little feathered Typhoid Marys that can fly to spread the virus.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Guests Quote  Post ReplyReply Direct Link To This Post Posted: January 13 2006 at 9:02am
Originally posted by Deej Deej wrote:

joe, basically what you are saying is that bf is a virus that wants to live, by killing its host, the chances of its survival are minimal, thus it needs to become less deadly and more easily spread ?... but what about the 1918 flu---  i have not read much in this area, how is this different, or similar?



H1N1 (Spanish Flu) had a higher than 1% lethality in 1918 - 1919.  Subsequent to that, it dumbed down and killed far fewer people. There was one H1N1 case recorded in the US a few weeks ago.  Since it is not as lethal, it is no longer called Spanish Flu.

H5N1 (Sichuan Sheet) has many of the characteristics of H1N1 Spanish Flu so people are saying that it will be just like H1N1.  I believe that modern medicine will prevent that from happening.  We aggressively go after Sichuan Sheet (Highly lethal post Qinghai Lakes) where ever it breaks out. (hospital ward isolation, Tamiflu and other antiviral drugs)  BUT, we will not go after a mild version of H5N1. 

Thus, modern medicine will actually work to prevent the spread of the killer strain, but will allow a milder strain to spread.  I believe it already has started in southern Asia.  The actions of the WHO seem to be covering up that spread, but it is happening.  I'd be willing to bet that a hundred million people are already positive for H5N1 antibodies, but most of them don't even remember getting sick in the past few years.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Paul Quote  Post ReplyReply Direct Link To This Post Posted: January 13 2006 at 9:05am
I've thought about this theory that if H5N1 is so virulent that it dumbs down or becomes less lethal so it won't die out itself, due to all it's hosts dying.  I'm not so sure this theory is correct and I've also read that it could actually mutate into a more lethal form.  For example: an army of H5N1 jumps from one animal to another.  The animal that it jumped to dies.  What's the herd of virus in the corpse going to do... radio back to the original hoard that it came from and say hey ease up on the potency, my troops are runniing out of food because this body has decayed to nothing but bones....I think not, viruses swirl and mutate in chaos.  If the virus becomes more or less virulent it's all due to chance.   To assume anything else would mean that it can communicate between seperate bodies or hosts.  Joe, I think you're theory is flawed.  This killer, once it starts in humans could be as lethal as it has been in chickens.
Seeking like minded individuals that would like to have a back up plan if this thing really takes hold. I'm in the midst of buying some very remote land and I need some earthy people to join me.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Deej Quote  Post ReplyReply Direct Link To This Post Posted: January 13 2006 at 9:05am

so the virus does not have to become milder, just has to find a way to spread - via the asymptomatic birds - yes ? - 

sorry these questions sound simple, just really need to my mind straight.

dee
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Guests Quote  Post ReplyReply Direct Link To This Post Posted: January 13 2006 at 9:10am
Now, you got it.  The asymptomatic birds are carrying the horrific killing machine virus that evolved at Qinghai Lakes.  That is the reason why it is much the same in the Ukraine and Turkey as it was in western China.

Now, the Turkish strain appears to have picked up a human compatibility gene.  If so, it can spread like a human flu virus and won't need the assistance of wild birds to transfer it slowly around the world.  Now it can spread in large aluminum "domesticated" birds.  It will do so.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Deej Quote  Post ReplyReply Direct Link To This Post Posted: January 13 2006 at 9:15am

think you both answered my questions- two different  directions, but i guess truth be told no one knows what will happen, it is all speculation. i think something is going down, can't really explain why, just that we have reigned over this planet in a cruel and indifferent way, and i think if you keep kicking the dog, eventually he'll bite.  i think bf might have very sharp teeth...

dee
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Post Options Post Options   Thanks (0) Thanks(0)   Quote DarlMan Quote  Post ReplyReply Direct Link To This Post Posted: January 13 2006 at 9:48am
OK,

Very good discussion BTW.

It seems that we are putting the lethal strain of H5N1 in the league with Ebola. A terrible killer, but so deadly that it kills itself out. Also, like Ebola it takes direct and prolonged contact (body fluids, etc) for infection to occur.

There is one wild card that cannot be over looked when dealing with an influenza virus. The incubation period between infection and becoming symptomatic has always given influenza an upper hand when moving from host to host.

We would have to say that the Spanish flu (1918) was the most deadly influenza in the modern era. Yet it managed to move around the globe with seeming ease. The overall death rate was on 2.5%, but the vast majority of people became ill enough to seek the bed or a hospital, which would mean that once symptomatic the chance for continued spread would diminish.

Therefore, do we know the incubation period of the Turkish strain of H5N1? That is do we know how long a period exist where a person is infected and contagious and the onset of frank symptoms?

If there is around a 48 hour period of infectious/contagious but not symptomatic then would that leave a window large enough for a virulent form of H5N1 to become a pandemic?

Has the WHO or any other agency discussed this? If so do they have a ballpark figure?
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Post Options Post Options   Thanks (0) Thanks(0)   Quote DarlMan Quote  Post ReplyReply Direct Link To This Post Posted: January 13 2006 at 10:15am
I am about to break one of my cardinal rules. I will ask your forgiveness in advance.

Here is a posting from a DR. on another Bird Flu Discussion board.

---
Dr. Niman

There is a definite increase of H2H in Turkey. The gap in the entry could indicate multiple exposure to the same common source, but almost all familial clusters have a significant gap, indicating most are H2H. Now with Turkey, the clusters are getting larger indicating H5N1 transmits to humans more efficiently regardless of source (chicken or human), but the onset date gap says its human.

The latest report seems to indicate more Ozkan family members have symptoms, which again points toward H2H. Ten family members were admitted between January 4-6 and at least 2 have tested H5N1 positive. Now there is a new round of infections a week later. There is a good chance that this represents H2H2H, which is NOT what WHO wants to see and certainly doesn't want the rest of the world to see, so disease onset dates have disappeared from their reports (and the last set of 5 admissions didn't even include gender or ages or the fact that one of the positives was the cousin of another positive).

Turkey has significant H2H, but WHO wants everyone to think it is B2H.
----

Do you think the WHO is currently informing world governments about the crisis before any public information is released?

Edited--- to add this

The following link has a very interesting story H2H

I have done enough work with Goverment agencies to know when the water is slowly being turned up so we don't know were boiling until....


Edited by DarlMan
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Madison View Drop Down
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Madison Quote  Post ReplyReply Direct Link To This Post Posted: January 13 2006 at 3:57pm
JoeNeubarth wrote:
>> The outbreak in Turkey is PQ Bird Flu.  (Post Qinghai mutated virus that I call Sichuan Sheet)  It has a high lethality.  Because of that, it does not spread as easily.

High lethality has absolutely no affect at all on how well a disease spreads. Zilch. Zero. Nada.


>>THAT is the reason I keep on saying that when it gets down to a lethality of approximately 1 percent or less THEN we will have a pandemic of "Mild Flu."  (Mild compared to the far higher lethality numbers bandied forth by so many on all of the flu boards.)

Ridiculous. Completely off the mark. 

Try this scenario on for size. Suppose there is Disease X which is 100% lethal. But also suppose that Disease X is able to incubate in the body for two months before becoming symptomatic. There are no medical tests that will detect it until I get sick. And during the two months Disease X was also easily transmissable between humans. If this were the case, Disease X would wipe out all human life on the planet.

Correct?

If I had Disease X I would be certain to die -- but not for two months. In the meantime though I'm extremely contagious.

When I pick up a Starbucks the money I hand the cashier is heavily contaminated. Anyone who handles it will be infected. When I touch a doorknob, when I hand out 20 reports at a meeting, when I hand a coworker a CD, when I kiss my husband, when I kiss my little girl, when I give a store clerk my Visa, when I hold onto the rails on the treadmill at the gym....  it's a death sentence. But I don't know it. I'm not sick. I have no symptoms. I feel great. 

If I should sneeze in an elevator at Macy's maybe a dozen prople get infected. But they would feel fine. Everybody else would feel fine too -- for 60 days.

In the meantime the gal at Starbuck's is infected and in a short while is passing on the disease to anyone who comes in the store. She's serves maybe 200 customers the day I got my coffee. And she grabs a handful of stir-sticks and fills a container. How many of them  did she actually touch?

On the 60th day I won't feel well. On the 61st day I'll be really ill and taken to a hospital. On the 63rd day I'll be dead. And during the 60 days when I thought I was OK I'd have sentenced hundreds -- maybe thousands -- of other people to their deaths.

Everyone who touched anything I did would be at risk -- unless they did a fantistic job at washing their hands right away after I've handed them something. How many people do that? Even doctors and nurses aren't all that great at washing their hands well all the time.

And if Disease X was able to live in wild birds -- without killing them or even making them sick -- wild birds would spread the disease even more quickly.

It's the incubation time that causes the problem.  If Disease X was 100% lethal but made people sick within hours of being contaminated, maybe, just maybe, the CDC could catch it in time.







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Post Options Post Options   Thanks (0) Thanks(0)   Quote Guests Quote  Post ReplyReply Direct Link To This Post Posted: January 13 2006 at 4:07pm
Madison, I can not argue with your logic.  The fact of the matter is that we have to deal with reality, not some trumped up scenario.

Reality shows us that most of those who are exposed to Sichuan Sheet (Post Qinghai Lakes H5N1) develop symptoms quickly, so your lengthly incubation period has little value. 

If conditions continue as at present, the severity of the flu is a major consideration in its ability to spread.  If people are quickly stricken and/or killed, they are not up and about and not spreading the virus.  Thus the virus limits itself.

If your argument held any water, Spanish Flu would still be transiting the globe, killing over 5% of all those who contacted it.  It isn't happening because Spanish Flu killed itself out by being too virulent.  H1N1 is still transiting the globe and is a mild flu.

Sichuan Sheet will do the same thing as Spanish Flu. 
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Madison Quote  Post ReplyReply Direct Link To This Post Posted: January 13 2006 at 4:11pm
Darlman wrote:
>> Now for a dumb question. If the strain in Turkey is of highly lethal strain and dead birds don't fly then why are so many saying Turkey was hit because of migratory patterns in wildbirds?

That's not a dumb question. That's a very good question. Many of the migratory birds that pass on Bird Flu are carriers and carriers ONLY. They don't get sick. The farmyard chickens that come near them get sick. Ducks too. And then the little kids who treat the chickens like pets get sick. There was a reporter on NPR who saw young children in Turkey kissing their sick birds -- to make then better.

The migratory birds are much like Typhoid Mary in New York City in the early 1900s. She passed on the disease to many people but never got sick herself. There was a great episode of Nova on PBS last year about the poor woman.

http://www.pbs.org/wgbh/nova/typhoid/


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Post Options Post Options   Thanks (0) Thanks(0)   Quote Madison Quote  Post ReplyReply Direct Link To This Post Posted: January 14 2006 at 5:36am
JoeNeubarth  wrote:

>>Madison, I can not argue with your logic.  The fact of the matter is that we have to deal with reality, not some trumped up scenario.

Trumped up means -- false and deliberately invented. If the logic of my imarinary Disease X was false why do you not argue with it? If the logic is incorrect argue with me. Tell me why.

>>Reality shows us that most of those who are exposed to Sichuan Sheet (Post Qinghai Lakes H5N1) develop symptoms quickly, so your lengthly incubation period has little value. 

It was a _hypothetical_ case to show how high lethality need not cause a disease to fade out -- as you continue to suggest.  hHIV/AIDS had almost 100% lethality in its early years, but it is still with us and is killing millions around the world to this day.

----
This from the Web:  http://www.ssc.wisc.edu/cde/cdewp/95-31.pdf
A final characteristic of HIV/AIDS is its high lethality. Available evidence indicates that virtually all individuals who contract the virus and develop AIDS will die within a period no longer than three years after the onset of AIDS and that their deaths will be due to some of the ailments
brought about by the collapse of the immune system.
----

>>If your argument held any water, Spanish Flu would still be transiting the globe, killing over 5% of all those who contacted it.  It isn't happening because Spanish Flu killed itself out by being too virulent.  H1N1 is still transiting the globe and is a mild flu.

Five percent?! That is extremely low lethality compared to HIV/AIDS -- is it not? Why didn't HIV/AIDS kill itself out then?  OK -- I'll tell you. It's because of the very long incubation time. The long incubation time allowed it to be spread for a years before the victim got sick. High lethality has nothing to do with causing a disease to fade away. Just as I had tried to explain with my imaginary Disease X.

>>Sichuan Sheet will do the same thing as Spanish Flu.

What is Sichuan Sheet?





Edited by Madison
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Corn Quote  Post ReplyReply Direct Link To This Post Posted: January 14 2006 at 6:43am

We keep hearing mention of birds spreading the virus however considering what is going on in Turkey we don't have to worry about birds.

It's humans spreading the virus. If anything the birds should avoid human contact. From this point out we could be giving it to birds, pets, pigs, cattle. Its not the birds that are the main threat now, it's the Humans.



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Post Options Post Options   Thanks (0) Thanks(0)   Quote phyrefly Quote  Post ReplyReply Direct Link To This Post Posted: January 15 2006 at 2:00am

As in sandfly-vectored leishmaniasis, the reservoirs always already have the most potential for mutation. Man for sandflies is simply an opportunity. As well, time means nothing to the collective influenza viral genome waiting in the wild. Mutations (if any)are going on both behind one's back, and right under their noses. Qinghai migratories aside, H5N1 in either the Quelpart Sparrow (Passer montanus saturatus Stejneger), or Korean Magpie (Pica pica japonica Temminck & Schlegel), seems to hold the most danger of creating and spreading a pandemic, and as well, hold the most potential for development of anti-influenza technologies. As I've stated elsewhere, chip technology holds promise as a monitoring, sentinel technology. This technology is compromised by the complexity of the vector(s): P. montanus shows lighter weight offspring in comparison to the domestic sparrow Passer domesticus. Nevertheless, it is the galvanic response to pregnancy as this relates to influenza viruses that is being pointed to in this example. There will likely appear in the future, other monitoring technologies.

Another example of the complexity, from the epidemiologcal side, is that of the relationship twixt Red Jungle Fowl Gallus gallus and Gallus domesticus, via time and geography, or 'WHY Russia is Working With Vietnam On New Vaccines.' One cannot compare Qinghai avian influenza to Turkish outbreaks unless one includes within the discussion the fact that there have been Turkish (and maybe Kurdish genes in cohabitation with sparrows and magpies) setting in Yakutia for much longer than introduced P. montanus has been setting in the U.S. along with its neighbor, P. domesticus. Theoretically, this places Turkey in Yakutia with a drastic change of temperature, environment, and the effects of time on collective genomes of multiple vectors and hosts. This could be called a 'double blackmail' but truly, numbers (double, triple, ad infinitum), like time, mean nothing in the strive to elucidate. The blackmail is quadrupled (or worse?) when genetics of another vector coincide sympatrically with P. montanus hispaniolensis, while simultaneously shifting the geography and genes!

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